scholarly journals Assessment of Association Between Venous Occlusion and Infection of Cardiac Implantable Electronic Devices

Angiology ◽  
2021 ◽  
pp. 000331972110383
Author(s):  
Andreas Keyser ◽  
Carsten Jungbauer ◽  
Janine Rennert ◽  
Birgit Linnemann ◽  
Christof Schmid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Odds Ratio ◽  
Electronic Devices ◽  
Venous Occlusion ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients ◽  
Novel Oral Anticoagulant ◽  
Device Infection ◽  
Anticoagulant Medication

The increasing number of patients treated with cardiac implantable electronic devices (CIEDs) and indications for complex pacing requires system revisions. Currently, data on venous patency in repeat CIED surgery involving lead (re)placement or extraction are largely missing. This study aimed to assess venous patency and risk factors in patients referred for repeat CIED lead surgery, emphasizing CIED infection. All consecutive patients requiring extraction, exchange, or additional placement of ≥1 CIED leads during reoperative procedures from January 2015 to March 2020 were evaluated in this retrospective study. Venography was performed in 475 patients. Venous patency could be assessed in 387 patients (81.5%). CIED infection with venous occlusion was detected in 74 patients compared with venous occlusion without infection in 14 patients ( P < .05). Concerning venous patency, novel oral anticoagulant medication appeared to be protective ( P < .05; odds ratio [OR]: .35). Infection of the CIED appeared to be strongly associated with venous occlusion (OR: 16.0). The sensitivity was only 64.15%, but the specificity was 96.1%. Number of leads involved and previous CIED procedures were not associated with venous occlusion. In conclusion, in patients with CIED, venous occlusion was strongly associated with device infection, but not with the number of leads or previous CIED procedures.

scholarly journals IMPLANTABLE CARDIAC DEVICE INFECTION - A CLINICAL AUDIT

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S871-75
Author(s):  
Muhammad Asad ◽  
Qurban Hussain Khan ◽  
Mir Waqas Baloch ◽  
Kumail Abbas Khan ◽  
Muhammad Amer Naseem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Rate ◽  
Clinical Laboratory ◽  
Electronic Devices ◽  
Laboratory Data ◽  
Site Infection ◽  
Cardiac Device ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
Device Infection

Objective: Cardiac Implantable Electronic Devices are being implanted more commonly now compared to the past. Due to the rise in implantation rate complication have also considered to increase. One of the dreadful complications is devices infection. This study was conducted to assess retrospectively the rate of device infection and risk factors associated with it. Study Design: Observational study. Place and Duration of Study: AFIC/NIHD, Rawalpindi, from Jan 2018 to Jan 2019. Methodology: A total of 356 patients who underwent cardiac devices implantation. Their records were studied and all the patients who developed device infections were further reviewed in detail. Demographic details, clinical, laboratory data and imaging records were evaluated. Patients were classified into different categories of infections based on predefined criteria according to the guidelines. Risk factors were also taken into account. Results: Out of 356 devices 14 got infected and infection rate was 3.9%. Generator site infection was seen in 6 followed by generator erosion in 5 while 2 had pocket site infection with bacteremia and 1 developed pocket site infection with lead/valvular endocarditis. Dual chamber permanent pacemakers were infected the most. Denovo devices had high infection rate compared to replacement. Microbes were identified in 3 patients. Conclusions: Our findings suggest that the increasing incidence of Cardiac Implantable electronic devices infection in current clinical settings was multifactorial. Care should be taken at every step starting from preoperative, intraoperative to postoperative stage for prevention of device infection.

An Analysis of Dental Implants Survival and Success

2018 ◽  
Vol 69 (9) ◽  
pp. 2465-2466
Author(s):  
Iustin Olariu ◽  
Roxana Radu ◽  
Teodora Olariu ◽  
Andrada Christine Serafim ◽  
Ramona Amina Popovici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Medical History ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Health Related

Osseointegration of a dental implant may encounter a variety of problems caused by various factors, as prior health-related problems, patients� habits and the technique of the implant inserting. Retrospective cohort study of 70 patients who received implants between January 2011- April 2016 in one dental unit, with Kaplan-Meier method to calculate the probability of implants�s survival at 60 months. The analysis included demographic data, age, gender, medical history, behavior risk factors, type and location of the implant. For this cohort the implants�survival for the first 6 months was 92.86% compared to the number of patients and 97.56% compared to the number of total implants performed, with a cumulative failure rate of 2.43% after 60 months. Failures were focused exclusively on posterior mandible implants, on the percentage of 6.17%, odds ratio (OR) for these failures being 16.76 (P = 0.05) compared with other localisations of implants, exclusively in men with median age of 42 years.

Consensus document on radiotherapy in patients with implantable pacemakers and cardioverter – defibrilators

2018 ◽  
Vol 2 (47) ◽  
pp. 27-31
Author(s):  
Lidia Chmielewska-Michalak ◽  
Ewelina Konstanty ◽  
Przemysław Mitkowski
Keyword(s):  
Current Knowledge ◽  
Clinical Status ◽  
Electronic Devices ◽  
Heart Rhythm ◽  
Complex Care ◽  
Consensus Document ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients ◽  
High Level ◽  
Emergency Mode

The number of patients with cardiac implantable electronic devices (CIED), who require oncological management including radiotherapy (RT) is still increasing. According to current knowledge the most frequent device dysfunction related to exposition to ionizing radiation is reprogramming to emergency mode (soft reset). There are uncommon cases of complete, irreversible device damage. CIED dysfunction during RT can be observed in approximately 3% of patients. In majority of cases they are asymptomatic, although in literature there are descriptions of deterioration of clinical status due to bradycardia or exacerbation of heart failure. The most important factor of device malfunction is radiotherapy with photons of energy >10 MV or protons despite energy used. So far there were no cases published with inadequate ICD therapies due to the presence of electromagnetic field interference during RT. Because patients with CIED undergoing RT need complex care to achieve high level of safety, experts of Heart Rhythm Society establish document, published in 2017 which summarized current knowledge about this group of patients. The document contains guidelines on peri-radiotherapy care of patients with CIED.

scholarly journals Risk factors associated with bleeding after multi antithrombotic therapy during implantation of cardiac implantable electronic devices

2016 ◽  
Vol 32 (3) ◽  
pp. 333-340 ◽  
Author(s):  
Kohei Ishibashi ◽  
Koji Miyamoto ◽  
Tsukasa Kamakura ◽  
Mitsuru Wada ◽  
Ikutaro Nakajima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antithrombotic Therapy ◽  
Electronic Devices ◽  
Factors Associated ◽  
Cardiac Implantable Electronic Devices

scholarly journals The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

2020 ◽  
Author(s):  
Soohyuk Yoon ◽  
Seokha Yoo ◽  
Min Hur ◽  
Sun-Kyung Park ◽  
Hyung-Chul Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Bispectral Index ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Anesthetic Depth ◽  
Intraoperative Hypotension ◽  
Cumulative Duration ◽  
The Relationship ◽  
Cumulative Time

Abstract Background The relationship between intraoperative low bispectral index (BIS) values and poor clinical outcomes has been controversial. Intraoperative hypotension is associated with postoperative complication. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

P4126Safety of magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices: A systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Padmanabhan ◽  
M Farwati ◽  
A Izath ◽  
A Al-Masry ◽  
D Kella ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Adverse Events ◽  
Meta Analysis ◽  
Electronic Devices ◽  
Binary Outcomes ◽  
Resonance Imaging ◽  
Pacing Threshold ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients

Abstract Recent guideline statements approve the performance of magnetic resonance imaging (MRI) in patients with non-conditional cardiac implantable electronic devices (CIEDs) under certain closely monitored conditions. Data from current registries may have lower power to discern changes that may occur in the CIED after the MRI. Objective We aimed to systematically review the literature to identify the adverse events and significance of changes in device function associated with performing MRI in patients with CIEDs Methods A comprehensive literature search of the databases was performed between 1980- 2017. Two independent reviewers selected studies and extracted data. A random-effects model was used for meta-analysis. Results A total of 7,422 patients underwent 8,865 MRI studies. No death occurred post MRI. Clinical adverse events were extremely rare (mostly less than 1%) and are summarized in Table 1. No significant changes in the pooled mean effect size estimate was noted for the changes in the lead parameters (pacing threshold, sensing and impedance) Binary outcomes post magnetic resonance imaging in patients with non-conditional cardiac implantable electronic devices Outcome Sample size Number of patients Rate SE LL of CI UL of CI Death 7401 0 0 0 0 0 Atrial arrhythmia 7173 10 0.001 0.0004 0.0007 0.0024 Ventricular arrhythmia 7371 9 0.0012 0.0004 0.0006 0.0022 Oversensing 4981 17 0.0034 0.0008 0.0020 0.0053 Inhibition of pacing 7371 6 0.0008 0.0003 0.0003 0.0016 Lead Failure/Generator Failure 7475/7475 2/8 0.0002/0.0011 0.0001/0.0004 0.0001/0.0005 0.0009/0.002 Power on Reset 1388 105 0.0131 0.0014 0.0107 0.0161 Did not complete scan 6851 13 0.0019 0.0005 0.0011 0.0031 Chest pain 7080 11 0.0021 0.0004 0.0008 0.0027. Lead threshold rise (>0.5v/>50%-A/V) 5076/6246 12/16 0.0024/0.0026 0.0007/0.0006 0.0013/0.0015 0.0040/0.0041 Change in Battery voltage >0.04V 7132 42 0.0061 0.0009 0.0043 0.0079 Sensing decrease >50%-A/V 5087/5834 17/9 0.0033/0.0015 0.0008/0.0005 0.0020/0.0008 0.0052/0.0028 Impedance changes >50ohms/>50% 5810 22 0.0038 0.0008 0.0024 0.0057 Rise in cardiac enzymes 1703 26 0.0152 0.0030 0.0102 0.0219 A, atrial; V, ventricular; SE, standard Error; LL, lower limit; UL, upper limit; CI, Confidence intervals. Conclusions MRI in patients with non-conditional CIEDs can be performed with high degree of safety and low rate of clinical events when performed under standardized protocols Acknowledgement/Funding None

scholarly journals The cumulative duration of bispectral index less than 40 concurrent with hypotension is associated with 90-day postoperative mortality: a retrospective study

2020 ◽  
Author(s):  
Soohyuk Yoon ◽  
Seokha Yoo ◽  
Min Hur ◽  
Sun-Kyung Park ◽  
Hyung-Chul Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Retrospective Study ◽  
Abdominal Surgery ◽  
Bispectral Index ◽  
Odds Ratio ◽  
Postoperative Mortality ◽  
Anesthetic Depth ◽  
Cumulative Duration ◽  
Cumulative Time

Abstract Background The influence of intraoperative low bispectral index (BIS) values and hypotension on poor clinical outcomes has been controversial. The purpose of this study was to investigate the influence of intraoperative low BIS values and hypotension on postoperative mortality in patients undergoing major abdominal surgery. Methods This retrospective study analyzed 1,862 cases of general anesthesia. We collected the cumulative time of BIS values below 20 and 40 as well as electroencephalographic suppression and documented the incidences in which these states were maintained for at least 5 minutes. Durations of intraoperative mean arterial pressures (MAP) less than 50 mmHg were also recorded. Multivariable logistic regression was used to evaluate the association between suspected risk factors and postoperative mortality. Results Ninety-day mortality and 180-day mortality were 1.5% and 3.2% respectively. The cumulative time in minutes for BIS values falling below 40 coupled with MAP falling below 50 mmHg was associated with 90-day mortality (odds ratio, 1.26; 95% confidence interval, 1.04-1.53; P = .019). We found no association between BIS related values and 180-day mortality. Conclusions Delicate adjustment of anesthetic depth is important to avoid excessive brain suppression and hypotension, which could be associated with postoperative mortality.

scholarly journals Bortezomib administration is a risk factor associated with the development of tumor lysis syndrome in male patients with multiple myeloma: A retrospective study

2020 ◽  
Author(s):  
Masahiro Kondo ◽  
Yuji Hotta ◽  
Karen Yamauchi ◽  
Akimasa Sanagawa ◽  
Hirokazu Komatsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Odds Ratio ◽  
Tumor Lysis Syndrome ◽  
Low Risk ◽  
Primary Therapy ◽  
Novel Therapies ◽  
Tumor Lysis ◽  
Number Of Patients ◽  
Increased Risk

Abstract Background Many novel medicines such as proteasome inhibitors have been developed during the last decade to treat multiple myeloma. Although multiple myeloma is defined as a low-risk disease for developing tumor lysis syndrome (TLS), treatment with these novel therapies might increase TLS risk. In fact, there have been some prior reports of bortezomib-induced TLS in patients with multiple myeloma. However, almost all of them have been case reports or case series. Thus, we investigated the risk factors for TLS in multiple myeloma patients. Methods We retrospectively investigated incidences of laboratory and clinical TLS (LTLS and CTLS, respectively) in patients who received primary therapy for treatment-naive, symptomatic multiple myeloma between May 2007 and January 2018. We used multivariate logistic regression analyses to evaluate the associations between LTLS and several parameters previously reported to be associated with increased risk. Results This study included 210 patients, seventeen (8.1%) and seven (3.3%) patients with LTLS and CTLS, respectively. The characteristics of the administered anticancer or prophylactic antihyperuricemic agents were similar between the patients with and without LTLS. Multivariate analyses revealed that LTLS was most strongly associated with bortezomib-containing therapy (odds ratio = 3.40, P = 0.069), followed by male sex (odds ratio = 2.29, P = 0.153). In a subgroup analysis focused on men, treatment with bortezomib-containing therapy was significantly associated with increased risk of LTLS (odds ratio = 8.51, P = 0.046). Conclusion In the present study, we investigated the risk factors for developing TLS in 210 multiple myeloma patients, which, to the best of our knowledge, is the largest number of patients reported to date. Furthermore, this study is the first to evaluate TLS risk factors in MM by adjusting for the effects of potential confounding factors in patients’ backgrounds. Consequently, we found that bortezomib-containing therapy increases the risk of TLS in male multiple myeloma patients. TLS risk should be evaluated further in low-risk diseases such as multiple myeloma, as an increasing number of novel therapies can achieve high antitumor responses.

Sign in / Sign up

Export Citation Format

Share Document